When Friends Relapse

A Guide to Responding in a Healthy and Helpful Way

You knew it was coming. You talked about it with your OWN sponsor. You prayed for him or her. You talked about the situation in meetings. Hell, you wrote about it in your freakin’ journal!

Or maybe you didn’t. Maybe you thought it would all just… Work itself out. Maybe you’re so early in your own recovery journey that this is the first time someone close to you has experienced a scary relapse, the kind of slip where you can only visit them in a hospital or a jail or the morgue. Maybe you’ve forgotten how deadly this disease can be. Maybe you’ve forgotten how frequently we alcoholics and addicts die.

On the other hand, perhaps you DID try. In conversation with your friend, perhaps you suggested they put more energy into their program (with all the terrified subtlety of a republican Presidential candidate speaking at a Seattle Teacher’s Convention). Perhaps you got loud. Perhaps you cut them out of your life, saying something like: “If you’re not going to take your recovery seriously, I can’t hang out with you anymore.”

Possibly they were a part of your social circle. Or your sponsee. Or your BEST friend. Or possibly you were dating. No matter what part they played in our lives, when good friends relapse, our emotions go into a cycle of crazy:

We feel guilty (Should I have said more? Should I have said something different?),

We feel angry (How could they? They’re so stupid!),

We feel hurt (I’ve lost my best friend, my boyfriend, this man or woman I’ve invested time and energy into helping get better….)

No matter the scenario, when someone close to us relapses, we have a hard time knowing how to react.

Relapse is not a (necessary) part of recovery.

It’s not. I know a number of “one chip wonders.” I love them. Hell, I sponsor a few.

People who “get it” from the very beginning of their journey are not unicorns.

Nevertheless, many people addicted to drugs and alcohol experience a cycle of hopeful exodus and painful return; going from active alcoholism and drug use into fresh periods of recovery, swinging back-and-forth from optimism to despair, in-and-out of the rooms for months or years or a lifetime, a seesaw born in Hell of stubbornness and dishonesty they can’t seem to climb off of…

And all this DESPITE the love and best efforts of friends, sponsors and family.

My own recovery was characterized by multiple relapses until I hit a soul-crushing bottom, a state of being so terrible I was FORCED into a place of honesty. From there I became willing to follow directions and KEEP FOLLOWING THOSE DIRECTIONS EVEN WHEN I FELT BETTER. I didn’t break out of the cycle of abuse because I was awesome. I didn’t “get it” because I worked hard, because I got the “right” sponsor or because I worked the “right” sort of twelve steps. It was none of those things.

My first honest white chip had almost NOTHING TO DO WITH ME.

As Bill W writes about in the 12&12, I searched “for something better” because of my circumstances, not as a result of moral strength or intellect or willpower.

Therefore, we who are alcoholics can consider ourselves fortunate indeed. Each of us has had his own near-fatal encounter with the juggernaut of self-will, and has suffered enough under its weight to be willing to look for something better. So it is by circumstance rather than by any virtue that we have been driven to A.A., have admitted defeat, have acquired the rudiments of faith, and now want to make a decision to turn our will and our lives over to a Higher Power.

(Twelve and Twelve, 38)

But what of our friends? What of people who are close to us, who enter AA or NA the way we did, who seem to do well for a time and then slip away? What of them? Why didn’t the program work? WHY?

Good question.

Bill W’s views on relapse changed over the years.

When he had less than five years of continual sobriety, he told women married to alcoholics that either God had removed the alcohol problem or he had not. In 1939, his ideas on relapse were cut and dried:

Perhaps your husband will make a fair start on the new basis, but just as things are going beautifully he dismays you by coming home drunk. If you are satis­fied he really wants to get over drinking, you need not be alarmed. Though it is infinitely better that he have no relapse at all, as has been true with many of our men, it is by no means a bad thing in some cases. Your husband will see at once that he must redouble his spiritual activities if he expects to survive. You need not remind him of his spiritual deficiency—he will know of it….

If he gets drunk, don’t blame yourself. God has either removed your husband’s liquor prob­lem or He has not. If not, it had better be found out right away. Then you and your husband can get right down to fundamentals. If a repetition is to be pre­vented, place the problem, along with everything else, in God’s hands. (BB; 121)

Ten years later, Bill was markedly more circumspect:

“It does not seem to pay to argue with ‘slippers’ about the proper method of getting dry. After all, why should people who are drinking tell people who are dry how it should be done?

“If they are too noisy or troublesome, amiably keep out of their way.”

(LETTER, 1942)

And twenty years after THAT, Bill W. gave a talk called The “Slipper” Needs Understanding. His views had entirely shifted; towards the end of his life, Bill essentially said we alcoholics aren’t entirely certain why some relapse while others do not:

Slips can often be charged to rebellion; some of us are more rebellious than others. Slips may be due to the illusion that one can be ‘cured’ of alcoholism. Slips can also be charged to carelessness and complacency. Many of us fail to ride out these periods sober. Things go fine for two or three years–then the member is seen no more. Some of us suffer extreme guilt because of vices or practices that we can’t or won’t let go of. Too little self-forgiveness and too little prayer–well, this combination adds up to slips.

Then some of us are far more alcohol-damaged than others. Still others encounter a series of calamities and cannot seem to find the spiritual resources to meet them. There are those of us who are physically ill. Others are subject to more or less continuous exhaustion, anxiety, and depression. These conditions often play a part in slips–sometimes they are utterly controlling.

TALK, 1960

We may NEVER know the cause of our loved one’s relapse and our ignorance is frightening. If our friends can so easily relapse, what of us? Are we at risk as well?

We must each remember that relapse NEVER happens in an instant: it is ALWAYS a string of choices, a gradual process of working the steps in reverse, a tick-tock transformation of weeks or months or years. For more information, check out our blog post Guarding Against Relapse.

It is heartbreaking to find a close friend or loved one returning to a course of self-destruction, to discover a friend mired again in the depths of using hell. Depending on the person and their drug-of-choice, the distance to the bottom can be very, very short.

For we who remain behind— still sober, still going to meetings — feeling let-down is normal. We’ve done so much to help the suffering friend! On the surface at least, our efforts seem to have been a vanity, just a bunch of wasted time and trouble on one who will never “pay it forward.” For the surviving friends and family, for those experiencing such terrific upheaval second-hand, mild-to-severe depression and spiritual discomfort are common.

These are the darker facts of our recovery experience. We must not shirk from unpleasant truths. We must face them head on, all the while taking greater care with our OWN program of twelve step work. All through this post I’ll say it again and again: before we can support our relapsing friends, we must put additional effort into shoring up our own programs.

Take care of yourself!

But what else? What can we do to help our friend? What should we not do?

Let’s begin with a list of Attitudes and Actions to Avoid

DON’T dismiss the problem. Don’t make excuses for their choices. Don’t do this when you’re talking to them; don’t support their rationalizations when talking about them. “He didn’t feel welcome at his home group; her sponsor didn’t call her back quickly enough.” These are NOT rational reasons to start killing yourself. Don’t buy into that garbage.

On the other hand, DON’T take on your loved one’s problems. Refrain from saying things like: “It’s no big deal. You have plenty of time to play the game. You can do whatever you want and come back when you’re ready.”

It IS a big deal. They may NOT have “plenty of time. The doors of AA and NA are always open to our returning family members, but they have to be alive to walk through them.

DON’T push: Once you’ve urged your loved one to reconnect with the recovery family, take a step back. It is NEVER my job to get an addict better. We are a program of attraction, not promotion.

A number of years ago, my best friend picked up and started using again. He passed out on my Thanksgiving table after making a number of inappropriate comments; he came to my house high on Christmas morning. During the whole experience, I worked hard to avoid evangelizing my friend with recovery slogans and lame, worn-out cliches. He eventually made it back, but only after I removed myself from contact, excepting our interaction at meetings. Why did I back so far away? Why didn’t I try to “talk him in to the rooms of recovery?”

Here’s why: I had a good sponsor who reminded me that: “No one has ever been inspired to return to the rooms by a friends saying ‘Well, Keep Coming Back! It Works If You Work It!’”

DON’T absolve them of responsibility: Don’t try to diminish guilt or anxiety about the relapse. Once again: don’t dismiss their relapse as if it’s insignificant or unimportant. They are actively playing Russian Roulette with their lives, spinning the bullet chamber and hoping the trigger will click on empty. They are stealing your emotional wellbeing. Don’t act as if that’s okay. It’s not.

— on the other hand —

DON’T try to make them feel guilty, either: If they aren’t already feeling a garbage truck’s worth of guilt and shame over their behavior, you trying to force them to recognize exactly how big a piece of shit they are isn’t going to work either. No one has ever been motivated to return to the rooms of AA and NA by someone saying “Look what you’ve done to me!”

Actions and Attitudes to Take

DO stand firm: Hold addicts accountable for their recovery. They will tell you things like “It didn’t work for me. No one at AA or NA really gave a shit. They’re a bunch of hypocrites.” Or they will make excuses like: “I was so depressed. I was overwhelmed. Work was hard. My girlfriend or boyfriend broke up with me.” Remind them what the Big Book Says: “Every alcoholic or addict — every single one — can recover regardless of their circumstances.” Just as it was important to hold them accountable for their behavior during their addiction, it is equally important to hold them accountable for what they did and didn’t do during their recovery.

DO encourage them: Redirect them to the steps and the program. Suggest they go talk to their sponsor. If they fight the idea (and they frequently will) suggest they go find a NEW sponsor.

They won’t like it. So-the-fuck what? Every conversation I have with a relapse-prone person focuses on them going to meetings, working the steps, cooperating with a sponsor. I regularly suggest my relapsing friends talk with others who share their problem.

I find that stressing the solution is my best and single answer. If they want to talk about the “whys” of their relapse, I point them towards what Bill writes about the “whys” in the Twelve and Twelve:

To clergymen, doctors, friends, and families, the alcoholic who means well and tries hard is a heartbreaking riddle. To most A.A.’s, he is not. There are too many of us who have been just like him, and have found the riddle’s answer. This answer has to do with the quality of faith rather than its quantity. This has been our blind spot. We supposed we had humility when really we hadn’t. We supposed we had been serious about religious practices when, upon honest appraisal, we found we had been only superficial. Or, going to the other extreme, we had wallowed in emotionalism and had mistaken it for true religious feeling. In both cases, we had been asking something for nothing. The fact was we really hadn’t cleaned house so that the grace of God could enter us and expel the obsession. In no deep or meaningful sense had we ever taken stock of ourselves, made amends to those we had harmed, or freely given to any other human being without any demand for reward. We had not even prayed rightly. We had always said, “Grant me my wishes” instead of “Thy will be done.” The love of God and man we understood not at all. Therefore we remained self-deceived, and so incapable of receiving enough grace to restore us to sanity. (12&12; 32)

Reading this section will either help them or shut them up. Either way, it’s a win.

DO take care of yourself: We hate to hear it, but the single best way to help an addict who relapsed is to take good care of your own program, your own health, your own spiritual life.

Eat well, get enough sleep, be sure to exercise, and keep doing the things you like: hobbies, sports, crafts, — whatever it is you enjoy. If you stay in the program for any considerable length of time, you are sure to lose friends and loved ones to the disease. Our life doesn’t stop because their life has gone off the rails. It can’t.

DO set an example for healthy living: If you’re on your way to Starbucks and they text you with how lonely and isolated they feel, invite them to join. Then IMMEDIATELY get in touch with another friend in recovery who will come. The same holds true for going to meetings. Always try to meet with your friend who has relapsed with another person in recovery. We do these things in “twos.” It’s safer for everyone.

Letting them know you’d enjoy their company is supportive. Just remember you can’t force them to accept the invitation.

DO be supportive WITHOUT engaging: Don’t spend any appreciable amount of time alone with your using friend. Treat every interaction as a twelfth step call; DON’T GO ALONE!

Please note:

Relapsers hate to relapse alone: they tend to find someone to take down with them. You may find yourself ambushed with the free availability of your drug of choice, you may find their negativity and pessimism infecting your thought life, you may find that you are starting to think of using again just by being in close proximity to someone who has surrendered to their disease.

Remember they are sick. If we aren’t careful, we can get sick too. Sick people ALWAYS get healthy people sick (not the other way around).

When my husband has the flu, I bring him soup; I run to the store for medicine; I make him hot tea. We DON’T snuggle. That shit is contagious.

Speaking of husbands… What should you do if it is your boyfriend or girlfriend who relapsed? Should you break up? What if you are living together? Should you kick them out? What if the relationship is between someone with time and someone fairly new- in other words: What if I was thirteen-stepping a person who relapsed? Is it my fault?

These are difficult questions and much depends on circumstance. Talk to your sponsor. If they don’t have any ideas, talk to someone else, perhaps someone with more time or more experience. And PLEASE REMEMBER… we are not a one-size-fits-all organization; we should never say Just do “this” and everything will work out.

One of my favorite lines in the literature is this:

Here no specific rule can be given.

Staying Positive

It’s important to have a positive outlook, both for your sake and the sake of your loved one.

DON’T be discouraged: Many, many, many alcoholics and drug addicts experience relapse; not just once, but over and over. This is not abnormal, nor does it spell the end of the road for your loved one. According to the National Institute on Drug Abuse, drug addiction is like many other chronic illnesses that require more than one round of treatment. Just because addicts relapse and need another course of treatment doesn’t mean their treatment has been unsuccessful or that they won’t be able to stay “clean” in the long run.

In a famous letter to an AA member who relapsed, Bill Wilson wrote:

“About this slip business — I would not be too discouraged. I think you are suffering a great deal from needless guilt. For some reason or other, the Lord has laid out tougher paths for some of us, and I guess you are treading one of them. God is not asking us to be successful. He is only asking us to try to be. That, you surely are doing, and have been doing. So I would not stay away from A.A. through any feeling of discouragement or shame. It’s just the place you should be.”

which is to say…

DO be optimistic. The power of the twelve steps knows no boundary. We might not understand all the whys and what-ifs. We don’t need to. Maybe they weren’t ready. Maybe they hadn’t admitted to their innermost self that they were an alcoholic. Even though a relapse is not the outcome you were hoping for, a return to meetings or to formal addiction treatment may in time prove the foundation of a future, drug and alcohol-free life.

DO pray. DO pray often. DO talk about your pain and frustration in meetings.

DON’T listen to the assholes: there are people in AA and NA who spew bullshit like it’s free Koolaid. When they say “some have to die so that others may live” or “better them than me” feel free to walk the hell away.

This isn’t Star Trek.

Our dying friends aren’t Spock. “The needs of the many” doesn’t mean people I love need to relapse that I might survive. Some people in AA seem to forget that Alcoholism and drug addiction are a single disease of mind and body. We need sustained treatment, not the occasional martyr. Can you imagine a doctor saying such things to someone dying of cancer? “Sorry your treatment stopped working and you’re going to die soon. But cheer up! Your death is going to make someone else’s recovery that much easier!”

I refuse to believe the loving higher power who watches over us all “needs” my friend to die to save my life. In point of fact, I refuse to believe my Higher Power needs much at all.

Here follows a personal opinion and one not sanctioned by AA or NA or any of the other “A’s”: Any statement which implies some people “need” to relapse and suffer is utter, unmitigated, arrogance, a pile of morally-superior bullshit spewing out of an unwashed grave of unintelligible shityness.

Staying Sober When Our Friends Don’t

First of all, seek help. Find an AlAnon meeting and for GOD’S SAKE, GO TO IT.

Second, think carefully about the nature of your relationship. If we chose to remain in a close relationship with a relapsing alcoholic or addict, we are in the process — RIGHT NOW — of getting sick ourselves. Period.

If our interactions with friends in recovery are more socially-oriented than recovery-oriented, our relapsing friends are influencing us MORE than we are influencing them. Always.

Third, remember that relapse is an infectious state of mind.

Why? We recovering types have a difficult time setting boundaries. We may struggle with the question of whether we should cut them off, deciding to only see them at meetings (that is, if they are willing to attend at all). When we do see them, what do we talk about? What do we say to our relapsing friend that won’t sound douch-baggy? “How’s your disease treating you? Hit a new bottom yet? Doing some more research and destruction?”

Don’t say those things to someone you know and care about. Be compassionate. But be honest too.

Fourth, be honest with your friend. Share your concern. Always bring the conversation back to recovery. Never act like a twelve-step missionary seeking recruits or an elementary school hall-monitor, chiding the relapsing friend on their bad behavior. Remember what the Big Book says about the best attitude to take when working with someone who is using:

That the man who is making the approach has had the same difficulty, that he obviously knows what he is talking about, that his whole deportment shouts at the new prospect that he is a man with a real answer, that he has no attitude of Holier Than Thou, nothing what­ever except the sincere desire to be helpful; that there are no fees to pay, no axes to grind, no people to please, no lectures to be endured—these are the condi­tions we have found most effective.

(BB, 19)

Fifth, set good boundaries. Setting and keeping boundaries is difficult. It’s really difficult. At times, it feels impossible.

Even though it is hard, we must learn to say “no” when the addict wants money or to crash on our couch or a ride through the bad part of town. Learning to be strong with regards to the addict will help them, too. It is called “tough love” because it is tough for us to do it (not because it is “tough” on them). Sometimes this is the only sort of love that will help.

And Sixth: help, don’t enable

While it may be unwise to offer the addict unearned money and shelter, particularly when they are not doing anything to help themselves, we SHOULD offer help. That is, we can offer to drive them to a meeting, a homeless shelter, a detox facility, a rehab center…or to any other place that offers them the support they need. If they are using intravenous drugs, we and another friend in recovery might point them in the direction of places that offer clean needles or life-saving naloxone (to be used in the case of opiate overdose).

Before you take such a step, talk with your sponsor.

How about the Group?

How should the home group members respond when one of their own disappears?

In As Bill Sees It, we are reminded that relapse has HISTORICALLY been a difficult thing for AA members. He wrote:

An early fear was that of slips or relapses. At first nearly every alcoholic we approached began to slip, if indeed he sobered up at all. Others would stay dry six months or maybe a year and then take a skid. This was always a genuine catastrophe. We would all look at each other and say, “Who next?”

Today, through slips are a very serious difficulty, as a group we take them in stride. Fear has evaporated. Alcohol always threatens the individual, but we know that it cannot destroy the common welfare. (A.A. COMES OF AGE; 97)

Final thought:

The biggest thing that will keep an addict sick is to treat them with moral disdain.

If you wish to offer help, do so remembering that addiction is a disease, not a moral failing. For the same reason, relapse is a symptom of the disease of addiction, not a moral failing. There is a distinct process to relapse, a set of symptoms and behaviors that occur leading from healthy and happy to the first drink or hit. Learn the The Phases and Warnings Signs of Relapse and for GOD’S SAKE, DON’T TAKE IT PERSONALLY!

Each addict relapses for reasons that are all his own.

Stay hopeful, knowing that if the relapsing friend survives, the day will come when the AA in their head will make the booze (or whatever) in their system intolerable. If they survive long enough, they will get to the jumping off point again.

These observations would be academic and point­less if our friend never took the first drink, thereby setting the terrible cycle in motion. Therefore, the main problem of the alcoholic centers in his mind, rather than in his body. If you ask him why he started on that last bender, the chances are he will offer you any one of a hundred alibis. Sometimes these excuses have a certain plausibility, but none of them really makes sense in the light of the havoc an alcoholic’s drinking bout creates. They sound like the philosophy of the man who, having a headache, beats himself on the head with a hammer so that he can’t feel the ache. If you draw this fallacious reasoning to the attention of an alcoholic, he will laugh it off, or become irri­tated and refuse to talk.

Once in a while he may tell the truth. And the truth, strange to say, is usually that he has no more idea why he took that first drink than you have. Some drinkers have excuses with which they are satisfied part of the time. But in their hearts they really do not know why they do it. Once this malady has a real hold, they are a baffled lot. There is the obsession that somehow, someday, they will beat the game. But they often suspect they are down for the count.

How true this is, few realize. In a vague way their families and friends sense that these drinkers are ab­normal, but everybody hopefully awaits the day when the sufferer will rouse himself from his lethargy and assert his power of will.

The tragic truth is that if the man be a real alco­holic, the happy day may not arrive. He has lost control. At a certain point in the drinking of every alcoholic, he passes into a state where the most power­ful desire to stop drinking is of absolutely no avail. This tragic situation has already arrived in practically every case long before it is suspected.

The fact is that most alcoholics, for reasons yet ob­scure, have lost the power of choice in drink. Our so-called will power becomes practically nonexistent. We are unable, at certain times, to bring into our con­sciousness with sufficient force the memory of the suf­fering and humiliation of even a week or a month ago. We are without defense against the first drink.

(BB, 23&24)

AND

Few indeed are the practicing alcoholics who have any idea how irrational they are, or seeing their irrationality, can bear to face it. Some will be willing to term themselves “problem drinkers,” but cannot endure the suggestion that they are in fact mentally ill. They are abetted in this blindness by a world which does not understand the difference between sane drinking and alcoholism. “Sanity” is defined as “soundness of mind.” Yet no alcoholic, soberly analyzing his destructive behavior, whether the destruction fell on the dining-room furniture or his own moral fiber, can claim “soundness of mind” for himself.

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A.A. must and will continue to change with the passing years. We cannot, nor should we turn back the clock. However, I deeply believe that the principle of anonymity must remain our primary and enduring safeguard. As long as we accept our sobriety in our traditional spirit of anonymity we will continue to receive God's Grace.